IMMANUEL FAMILY PRACTICE NPI 1164487823

NPI Information

IMMANUEL FAMILY PRACTICE is a medical specialty clinic center in Greensboro, NC. The provider is an entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer). IMMANUEL FAMILY PRACTICE NPI is 1164487823. The provider is registered as an organization entity type.

The provider's business location address is:

5500 W FRIENDLY AVE
SUITE 201
GREENSBORO, NC
ZIP 27410-212
Phone: (336) 856-9996

The provider's authorized official is Betti D Reese .
The authorized official title is President and has the following contact phone number (336) 856-9996.

The CLIA number assigned to this NPI record is 34D1031665 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/18/2006 and was last updated on 12/10/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.